1750 /O,J O 0 {,�{ bA.YJ-ul.cr. �[/2 LOT NO.
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� �APPLICAT FOR PLUMBING PERMIT
d s'AUG 2 7 1962 OF CUPERTINO
DaCff — 0!VQCU 7CDTIPI(� 19(a Permit No. / 7� 0
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r—• Fee$
Application is hereby made to the City of Cupertino for a permit to install plumbing
pipes and/or fixtures listed on the reverse side hereof, and agrees to install said prices
4� and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all oth aws applicable thereto.
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Use of Premises
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PLUMBING INSPEROA
--r—fXl-CRrS UMBER M I R I
_ I UNITS I FEES II JUNITSI FEE:
Water Heater I Size
Water Closets Material
Bath rubs I� To Curb
Showers I I To Prop. Lore
Lavatories I 11 '1'0 Existing
Kitchen Not Conn.
Dish Washers I ��
Waste Disposals I I�
Wa?�oftencrs
TI �� STORM DRAINAGE
W I� Size
aMaterial
SiTo Main Drain
Comb;;Sink &Trays I To Curb
Dental Units 1I _
Drinking Fountains) 1 11
Floor Drains:. WATER SYSTEM
Hoppers �—�I'Size I I_
Restaurant Sinks Material
Sand raps I I �I TOTAL FEES
Urinals Fixture Fee
Area 5r—ains--F 1 11 Main Drain Fee
Water Leaders Storm Drain Fee
Sprinkler Valves I I I Water Sys. Fee
Pewit Fee ,p Q
TOTAL I / �I TOTAL FEE o b
RECORD OF INSPECTION
Partial Rough
Rough Coln let _
Final